Hướng dẫn bổ sung Vitamin D đúng cách cho trẻ và phụ nữ mang thai

Bài viết này sẽ giúp trả lời những băn khoăn của các bậc phụ huynh về bổ sung vitamin D đến khi nào, thời gian nào trong ngày bổ sung vitamin D là tốt nhất và bổ sung như thế nào là đúng cách. Đồng thời cung cấp thêm những hướng dẫn cụ thể cho những nhóm đặc biệt như phụ nữ mang thai và trẻ thừa cân béo phì.

Nên bổ sung vitamin D đến khi nào?

Vitamin D được xem là quan trọng và rất dễ thiếu hụt trong giai đoạn phát triển nhanh đến 5 tuổi. Báo cáo của WHO đầu tháng 2/2019 đã cân nhắc và đưa ra lời khuyên Vitamin D cho nhóm trẻ sơ sinh và trẻ nhỏ đến 5 tuổi:

Nhóm trẻ này có những nguy cơ cao ảnh hưởng bởi tia UV khi tắm nắng, mặt khác, các bé chưa phát triển hành vi ăn uống đầy đủ, nên thành phần thức ăn chứa đủ vitamin D là khó đạt được. Các rào cản trên đã làm nhóm này trở nên dễ thiếu hụt vitamin D.

Theo các khuyến cáo hiện tại từ các tổ chức Y Tế trên thế giới, trẻ dù bú mẹ hoàn toàn hay không hoàn toàn nên bổ sung với liều 300-400 IU vitamin D3/ngày kể từ lúc sinh cho đến 1 tuổi hoặc đến khi trẻ cai sữa/uống ít nhất 1 lít sữa có bổ sung vitamin D.

Trẻ từ 1 tuổi – hết 4 tuổi tùy vào lượng sữa hoặc thực phẩm bổ sung vitamin D nhận được. Liều lượng của trẻ khuyến cáo ở độ tuổi này nếu không uống được 1 lít sữa hoặc hay thụ động trong nhà như xem TV, ipad vẫn cần bổ sung 400 IU/ngày.

Nếu trẻ từ 5 tuổi hay người trưởng thành ít ra nắng trong khoảng từ 10h – 3h chiều, ít nhận được vitamin D từ thực phẩm… vẫn rất cần bổ sung vitamin D để phòng ngừa nguy cơ còi xương (với trẻ em) và loãng xương (với người lớn), cũng như làm tăng khả năng miễn dịch tự nhiên của cơ thể…

Bằng chứng hiện tại cho thấy việc bổ sung vitamin D từ thực phẩm bổ sung là cách hiệu quả và an toàn nhất. Dạng vitamin D tương thích với trẻ nhỏ là: Dạng nhỏ giọt hoặc Dạng xịt trực tiếp vào miệng như Dimao Vitamin D3 400 IU. Trong đó, dạng xịt như Dimao cho thấy khả năng hấp thụ vitamin D tốt hơn cũng như sự tiện lợi khi sử dụng và sự thích thú hợp tác của trẻ. Nhiều bằng chứng cho thấy bổ sung vitamin D đúng và đầy đủ có thể ngăn ngừa sự thiếu hụt vitamin D.

Thời gian nào trong ngày bổ sung vitamin D là tốt nhất

Bổ sung vitamin D tốt nhất là sau bữa sáng để tăng khả năng hấp thụ. Tuy nhiên, nếu cha mẹ không có thời gian vào buổi sáng có thể cho trẻ bổ sung sau các bữa ăn trong ngày miễn là trước 8 giờ tối bởi vì bổ sung vào buổi tối được tìm thấy có liên quan đến sự khó ngủ ở trẻ, TS. Lichstein, ĐH Alabama, Mỹ chia sẻ.

Nhóm cần bổ sung Vitamin D đặc biệt

1. Nhóm Phụ nữ mang thai:

Phụ nữ mang thai là nhóm đặc biệt có nguy cơ thiếu hụt Vitamin D, điều mà có thể ảnh hưởng đến thai nhi. Với bằng chứng hiện tại từ Cochrane Review này cho thấy vitamin D được bổ sung trong mang thai là quan trọng để duy trì không thiếu hụt vitamin D, và có thể giúp giảm các nguy cơ liên quan đến mang thai như tiền sản giật, đái tháo đường thai kì, thai nhẹ cân sau sinh và băng huyết sau sinh.

Kết quả Cochrane hiện tại cũng cho thấy bổ sung vitamin D riêng lẻ hơn là bổ sung vitamin D có thêm thành phần Canxi. Do đó, phụ nữ mang thai nên chọn loại vitamin D riêng biệt, tránh loại có chung với canxi trong thành phần.

Trong quyển sách xuất bản cùng với GS. Hassan gần đây tại London về dinh dưỡng khi mang thai, chúng tôi phân tích dữ liệu có bao gồm phụ nữ Châu Á, cũng tìm thấy sự quan trọng về bổ sung folate cũng cần riêng lẻ, giống như vitamin D.

Hơn nữa, BMI trước mang thai quá lớn của phụ nữ Châu Á cũng ảnh hưởng trong việc tăng cân khỏe mạnh từ thai kì thứ 2 cũng như thiếu hụt Vitamin D trong thai kì. Do đó, duy trì cân nặng ổn định trước mang thai 3 tháng là điều được khuyên.

Cụ thể về bổ sung vitamin D trong mang thai, hướng dẫn hiện tại của Hiệp hội Royal College of Obstetrics and Gynecology, Anh Quốc, là 400 IU/ngày cho phụ nữ mang thai có cân nặng bình thường, nhưng 1000IU/ngày cho phụ nữ mang thai có cân nặng thừa cân béo phì (BMI trước mang thai >23 kg/m2).
Riêng phụ nữ mang thai song sinh, theo hướng dẫn của Society of Maternal Fetal Medicine là 1000IU/ngày.

2. Nhóm trẻ thừa cân béo phì:

Theo khuyến nghị của của các chuyên gia dinh dưỡng thì trẻ từ 2 tuổi thừa cân béo phì ít vận động, sinh hoạt thụ động như xem TV, Ipad trong nhà có nguy cơ cao thiếu hụt vitamin D. Do đó, trẻ cần được xem xét bổ sung vitamin D liều cao hơn sau khi đánh giá các yếu tố nguy cơ khác với chuyên gia dinh dưỡng.

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  163. You could definitely see your skills in the paintings you write. The world hopes for even more passionate writers such as you who aren’t afraid to mention how they believe. At all times follow your heart. “In order to preserve your self-respect, it is sometimes necessary to lie and cheat.” by Robert Byrne.

  164. You are so cool! I don’t believe I’ve truly read through a single thing like this before. So good to find someone with unique thoughts on this topic. Seriously.. thanks for starting this up. This site is one thing that’s needed on the internet, someone with some originality!

  165. You could certainly see your expertise in the work you write. The sector hopes for more passionate writers such as you who aren’t afraid to say how they believe. All the time follow your heart. “Man is the measure of all things.” by Protagoras.

  166. You could certainly see your expertise in the work you write. The sector hopes for more passionate writers such as you who aren’t afraid to say how they believe. All the time follow your heart. “Man is the measure of all things.” by Protagoras.

  167. You can certainly see your skills within the paintings you write. The sector hopes for even more passionate writers such as you who aren’t afraid to mention how they believe. Always go after your heart. “There are only two industries that refer to their customers as users.” by Edward Tufte.

  168. You could definitely see your expertise within the work you write. The sector hopes for more passionate writers such as you who aren’t afraid to say how they believe. At all times go after your heart. “History is the version of past events that people have decided to agree upon.” by Napoleon.

  169. You can certainly see your skills within the paintings you write. The sector hopes for even more passionate writers such as you who aren’t afraid to mention how they believe. Always go after your heart. “There are only two industries that refer to their customers as users.” by Edward Tufte.

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  171. You could certainly see your expertise in the work you write. The sector hopes for more passionate writers such as you who aren’t afraid to say how they believe. All the time follow your heart. “Man is the measure of all things.” by Protagoras.

  172. You are so cool! I don’t think I’ve truly read through something like that before. So wonderful to find somebody with some original thoughts on this topic. Really.. thanks for starting this up. This website is one thing that is required on the internet, someone with some originality!

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  174. You are so interesting! I do not suppose I’ve truly read anything like this before. So wonderful to discover another person with some unique thoughts on this topic. Seriously.. thank you for starting this up. This site is one thing that is needed on the internet, someone with a bit of originality!

  175. You could certainly see your skills within the paintings you write. The sector hopes for more passionate writers like you who are not afraid to mention how they believe. All the time go after your heart. “The point of quotations is that one can use another’s words to be insulting.” by Amanda Cross.

  176. You are so interesting! I do not think I’ve read through something like that before. So nice to find somebody with unique thoughts on this subject. Seriously.. thanks for starting this up. This web site is one thing that is needed on the web, someone with a little originality!

  177. You can certainly see your skills within the paintings you write. The sector hopes for even more passionate writers such as you who aren’t afraid to mention how they believe. Always go after your heart. “There are only two industries that refer to their customers as users.” by Edward Tufte.

  178. You are so interesting! I don’t believe I have read through anything like this before. So great to discover somebody with a few genuine thoughts on this issue. Really.. many thanks for starting this up. This web site is one thing that is required on the web, someone with a little originality!

  179. You can definitely see your skills in the work you write. The world hopes for more passionate writers like you who are not afraid to mention how they believe. At all times follow your heart.

  180. You are so interesting! I do not think I’ve read through something like that before. So nice to find somebody with unique thoughts on this subject. Seriously.. thanks for starting this up. This web site is one thing that is needed on the web, someone with a little originality!

  181. You could certainly see your skills within the work you write. The sector hopes for more passionate writers like you who aren’t afraid to mention how they believe. At all times go after your heart. “The most profound joy has more of gravity than of gaiety in it.” by Michel de Montaigne.

  182. You can certainly see your skills within the paintings you write. The sector hopes for even more passionate writers such as you who aren’t afraid to mention how they believe. Always go after your heart. “There are only two industries that refer to their customers as users.” by Edward Tufte.

  183. You are so interesting! I don’t believe I have read through anything like this before. So great to discover somebody with a few genuine thoughts on this issue. Really.. many thanks for starting this up. This web site is one thing that is required on the web, someone with a little originality!

  184. You could certainly see your skills within the paintings you write. The sector hopes for more passionate writers like you who are not afraid to mention how they believe. All the time go after your heart. “The point of quotations is that one can use another’s words to be insulting.” by Amanda Cross.

  185. You are so interesting! I don’t believe I have read through anything like this before. So great to discover somebody with a few genuine thoughts on this issue. Really.. many thanks for starting this up. This web site is one thing that is required on the web, someone with a little originality!

  186. You can definitely see your skills in the work you write. The world hopes for more passionate writers like you who are not afraid to mention how they believe. At all times follow your heart.

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  188. You are so cool! I don’t think I’ve truly read through something like that before. So wonderful to find somebody with some original thoughts on this topic. Really.. thanks for starting this up. This website is one thing that is required on the internet, someone with some originality!

  189. You could definitely see your skills in the paintings you write. The world hopes for even more passionate writers such as you who aren’t afraid to mention how they believe. At all times follow your heart. “In order to preserve your self-respect, it is sometimes necessary to lie and cheat.” by Robert Byrne.

  190. You could certainly see your skills within the work you write. The sector hopes for more passionate writers like you who aren’t afraid to mention how they believe. At all times go after your heart. “The most profound joy has more of gravity than of gaiety in it.” by Michel de Montaigne.

  191. You can certainly see your skills within the paintings you write. The sector hopes for even more passionate writers such as you who aren’t afraid to mention how they believe. Always go after your heart. “There are only two industries that refer to their customers as users.” by Edward Tufte.

  192. You are so cool! I don’t think I’ve truly read through something like that before. So wonderful to find somebody with some original thoughts on this topic. Really.. thanks for starting this up. This website is one thing that is required on the internet, someone with some originality!

  193. You could certainly see your skills within the paintings you write. The sector hopes for more passionate writers like you who are not afraid to mention how they believe. All the time go after your heart. “The point of quotations is that one can use another’s words to be insulting.” by Amanda Cross.

  194. You could definitely see your skills in the paintings you write. The world hopes for even more passionate writers such as you who aren’t afraid to mention how they believe. At all times follow your heart. “In order to preserve your self-respect, it is sometimes necessary to lie and cheat.” by Robert Byrne.

  195. You are so cool! I don’t believe I’ve truly read through a single thing like this before. So good to find someone with unique thoughts on this topic. Seriously.. thanks for starting this up. This site is one thing that’s needed on the internet, someone with some originality!

  196. You can certainly see your skills within the paintings you write. The sector hopes for even more passionate writers such as you who aren’t afraid to mention how they believe. Always go after your heart. “There are only two industries that refer to their customers as users.” by Edward Tufte.